[pink2blue1]

Any peds nurses on, please...my 17 month old son spiked a temp of 103.5 rectally this afternoon just out of the blue. He has no symptoms of anything. No runny or stuffy nose, no cough, my ear check says fluid unlikely in one ear and monitor in the other. He's just cut 4 molars but I know you can't get a fever with teething above 102 (If that is even real!) I gave him the 1.825 dropper of advil 4 hours ago and he's only dropped to 101.5 rectally. I am worried about him. He's acting normal, maybe a tad bit quieter than usual. What can cause a temp like that from no where with no visible signs at all? the on call Dr was no help, he told me to check with my Ped in the AM...GRRRRRR!

Thanks,
Shannon-Visiting from the students forum-LVN class of 2006

[lady_jezebel]

I'm not a peds nurse, but I'm a new mom like you. Personally, I would give your on-call another page and ask why he's not concerned and if you should go to the emergency room. If he gives you a good explanation, then perhaps you could stagger doses of tylenol and ibuprofen to bring the fever down until morning (Dr. Sears claims it's safe to alternate these two drugs every 4 hrs, so that he is getting each one every 8 hrs). Also, give lots of fluids. Finally, watch for seizures -- or just go to the ER. If the on-call doesn't have a good explanation & you can't bring the fever down, I would go to the ER rather than worry all night that my child might have a seizure.

[SMK1]

not a nurse, but when my now 4yr old had the flu last winter ibuprofen wasn't touching her fever which was 103.2 on meds, at the urgent care they gave gave her a dose of tylenol and told me to alternate them, that finally brought the temp down. If you are worried though call the doc or go to the ER. I hope everything is alright.

[Atlnurstudt]

103.5 isn't a huge deal in a 17 month-old who is acting OK. Protocol (at least at my children's hosp.) is take to ER if over 103.5 and under 15 months old. My little one spiked 103.5 at 15 months with no signs or symptoms and it turned out to be a viral throat thing. Roseola (sp?) is another common childhood illness that spikes fevers with no other signs or symptoms, when the fevers stop, a rash starts. The most important thing in any child with fever is how they are acting when the fever is brought down. Most children are miserable when they are burning up. Now, I think you are supposed to take them to the ER with a temp. of 104.5 - 105.0 regardless of how they are acting due to the statistical corrolation of those temps. with bacterial disease (sepsis, UTI, etc.).

Hope that helps, what happened, btw??

Carrie

[pink2blue1]

Carrie, thanks for responding. Since then he went up to 105.1 the next night and then last night he got to 105.6. The Pediatrician on call looked at him yesterday morning and since his ear, lungs and nose were clear he suspects roseola, but his fevers are still up. He has NO other symptoms at all, besides the last 1 nights he's vomited at about 1AM, I think because he's too hot. That is the only time he's vomited and other than that during the day he's fine. Now I know I just started my nursing program, but I have been a CNA for 3 years and I know sometimes the nurses and mothers instinct are better than the Dr in some cases. I just feel like there is something more wrong with him. He's now had a fever for 72 hours and only yesterday did it get to normal for a few hours. I am going to call the on call Dr this morning since hte temp has gone down to 101 since giving advil. The other thing is he hasn't had a BM since wednesday, but he's not eating much either. He's been very wet though.

Thanks again for responding!

[sirI]

Originally Posted by pink2blue1

Carrie, thanks for responding. Since then he went up to 105.1 the next night and then last night he got to 105.6. The Pediatrician on call looked at him yesterday morning and since his ear, lungs and nose were clear he suspects roseola, but his fevers are still up. He has NO other symptoms at all, besides the last 1 nights he's vomited at about 1AM, I think because he's too hot. That is the only time he's vomited and other than that during the day he's fine. Now I know I just started my nursing program, but I have been a CNA for 3 years and I know sometimes the nurses and mothers instinct are better than the Dr in some cases. I just feel like there is something more wrong with him. He's now had a fever for 72 hours and only yesterday did it get to normal for a few hours. I am going to call the on call Dr this morning since hte temp has gone down to 101 since giving advil. The other thing is he hasn't had a BM since wednesday, but he's not eating much either. He's been very wet though.

Thanks again for responding!

3 days of FUO I would take him to ER. Not eating and ill, could be something you need to have evaluated further. If his temp is trying to reduce, then the illness may be running its course. But, use your inner feeling, never ignore that.

[jules_]

My son had these very same symptoms when he was 10 mos old. His fever went up to 105. It was very scarry. They used to call the method of Tylenol and Advil, piggy backing, Advil can be taken every 6 hours and then Tylenol every 4 hours. That way the fever does not have a chance of getting real high. Once it gets high it is hard to bring down. Advil was more effective for my kids over the years. Planning to give Advil before bedtime will give your child and you more opportunity for rest since it lasts 6 hours. I would wake him up to give meds otherwise he was miserable with fever. I gave my son ice chips and drink, pedialyte or gatorade by teaspoons so he would not throw up, and kept him from dehydrating. Also, lukewarm wash cloth on forehead back and stomach made him more comforatble and helped bring fever down. He was sick for 4-5 days, and of course my husband was out of town. You sound like you are doing everything right. Stay strong!!!!!!!

[Atlnurstudt]

At this point it seems like they should do some blood work, esp. cbc and crp to evaluate for bacterial infection. I would take to ER if you're not happy with your peds assesment. One ped missed the boat on my daughter and I took her to the ER w/ a temp of 105. Turned out to be a UTI and ER doc said it was very important that she was seen immediately, they even did a spinal tap. 105 is very high in a 17 month old and I think it's negligent not to at least check cbc.

Carrie

[Atlnurstudt]

btw, in the future, go to www.choa.org and complete the online assesment/protocol tool they have. It's extremely helpful after hours.

[schroeders_piano]

Am I the only nurse having a problem with a 17 month old with a fever of 105? It's my feeling that this child should have been seen in the ER with blood work being done and possible hospital admission for FUO.